Health workers at Salima District Hospital have demanded the immediate transfer of senior officers, among other accusations, claiming they neglect public patients while prioritizing the hospital’s paying ward, mismanage resources, and undermine staff welfare.
In a complaint addressed to the Minister of Health and Sanitation and copied to the Secretary for Health, the Minister of Local Government, and the District Commissioner for Salima, the workers allege that the hospital’s paying services, originally introduced to raise income for medicines and maintenance, have instead become a centre of privilege for a few.
“Returns from paying services are not catering for the intended purpose,” reads part of the letter. “The few are benefiting from the returns whilst the public wards are suffering from lack of resources, shortage of medicines and other supplies.”
They further allege that staff working in the paying ward receive substantial allowances despite being civil servants, and that some patients pay directly to the Sister-in-Charge. “Poor patients are told to buy medicines and supplies from the paying ward which gets its supplies from the main pharmacy. This is very unfair and unjust, and this has to stop immediately,” the workers wrote.
The staff also paints a grim picture of a collapsed referral system, saying all ambulances are currently grounded due to a lack of maintenance. They cite a tragic case on 1 February 2026 involving a woman referred from Mnema Health Centre with cord prolapse.
“They called for an ambulance but there was no response from the district hospital. The mother developed maternal distress. The patient and family decided to use their own means and boarded a motorbike. The patient died at the district hospital, a very preventable death,” the complaint states.
In another incident, an ambulance, registration number MG 664 AM, was reportedly taken for maintenance in August 2025 but allegedly ended up being used by Kindle Orphan Care. The workers also allege there has been no dedicated funding for vehicle maintenance since 2022, forcing drivers to contribute money for repairs.
They further question how funds from partners such as Amref Health Africa were utilised, alleging that spare parts from one vehicle were transferred to another while the allocated maintenance funds remain unaccounted for.
Concerns have also been raised over ongoing renovations at the female ward, male ward, and administration block, where workers claim contractors are using already damaged materials. “Work is being done but there is no value for money,” they allege.
Inside the wards, some patients are reportedly sleeping on beds without mattresses despite donations from well-wishers, including a container of assorted items donated by Muslim Relief UK through the British Embassy.
The hospital kitchen has also come under scrutiny, with patients reportedly receiving only one meal per day, mostly beans throughout the year. “When questioned, it is always issues to do with funding,” the staff wrote.
They allege that out of 450 bags of maize donated through the Green Belt, only 300 reached the hospital, leaving 150 bags unaccounted for. “The whereabouts of 150 bags is not known. However, payments are being justified using ORT funds, which is an audit query,” the complaint reads.
The nursing department is described as disorganised and lacking effective leadership, with the District Nursing and Midwifery Officer allegedly operating from Lilongwe instead of the district. They also question a night supervision arrangement where four nurses reportedly work only one week per month and receive an additional K45,000 allowance.
“We feel that this is not in order and very unfair to the rest of the nurses in the district,” they wrote.
In the clinical department, workers allege that public wards are largely attended by intern clinicians with minimal supervision, while the paying ward enjoys full-time qualified clinicians both during the day and at night.
“It seems that many efforts are put into the paying wards than the public wards which the majority of the population access health services,” the complaint states.
The staff have also raised concerns about the management of the hospital’s social welfare fund, alleging that the District Council exerts excessive control over money deducted from employees’ salaries.
“We request that the District Council should distance itself from welfare funds and let the committee do the needful,” they wrote.
Citing the cumulative concerns, the workers are demanding immediate transfers of the officers in question; DHS, DNMO, Principal Administrator, Hospital Administrator, Accountant, PHRO AND DMO. “Failing which, the hospital will go for a sit-in,” the letter warns.
